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INVITATION TO SUBMIT LEASE PROPOSAL STATE OF CONNECTICUT UNIVERSITY OF CONNECTICUT HEALTH CENTER
FACILITY CONTRACTS & LEASES Jennifer K. Kelley 263 Farmington Avenue, MC4039
Purchasing Services Officer Farmington, CT 06032 860‐679‐8091 [email protected] Email address
Acknowledgment: Receipt of Documents
Fax to 860‐284‐5872 Please return this acknowledgement as soon as possible, so your company can be added to the contact list for this solicitation and be sure to receive any addenda or
other information regarding the solicitation.
Solicitation Number Due Date Due Date Time
FCL‐0080‐8 September 25, 2009 3:30 PM
Title: Pediatric AIDS Program Office
Please check one of the following boxes: Submitting proposal NOT submitting proposal Print or type the following information: Company name:
Address:
City or Town:
Phone:
Fax:
Received by:
email:
INVITATION TO SUBMIT LEASE PROPOSAL NO.: FCL-0080-8
University of Connecticut Health Center
Pediatric Aids Program Office
The University of Connecticut Health Center (UCHC), Office of Facility Contracts & Leases is seeking lease proposals that meet the following criteria:
• Class A Office Space: minimum of 1250 to 1750 sq. ft. including space for a patient waiting area, 3-4 office space areas and a storage area.
• Proximity to associated clinical programs in the central Hartford area. • Good access to public transport systems. • American Disabilities Act (ADA) compliant. Prefer street level floor. • Parking: 6-10 vehicles. • Allowances for architectural services and fit-out. • Immediate Availability. • Minimum lease term of 3 years. • Standard Business hours: 7:00am to 9:00pm with weekend access as required. • Total Lease Cost.
Proposals will be accepted until 3:30 PM on September 25, 2009. Submit Proposal to Lease Space Form No. FCL-0080-8, State Contracting Affidavits and a “Notice of Listing Agreement”, if applicable. Lease proposal information and related forms may be obtained at the following link: http://purchasing.uchc.edu/huskybid/index.html The submission of a proposal does not bind the University of Connecticut Health Center. The University of Connecticut Health Center reserves the right to reject any and all proposals. Proposals should be addressed exclusively to: Via US Mail: University of Connecticut Health Center Attention: FCL-0080-8 Jennifer Kelley Facility Contracts & Leases PO Box 4039 Farmington, CT 06034-4036 Via other University of Connecticut Health Center express Attention: FCL-0080-8 Jennifer Kelley mail Facility Contracts & Leases – Munson Road Offices – Room P3042 carriers 263 Farmington Avenue Farmington, CT 06032
PROPOSAL TO LEASE SPACE FCL-0080-8 UNIVERSITY OF CONNECTICUT HEALTH CENTER Office Facility Contracts & Leases MC 4039 263 Farmington Avenue, Farmington, CT 06032
Solicitation Number Date Due Back Principal Contact Phone Number FCL-0080-8 September 25, 2009 at 3:30 PM Jennifer Kelley 860-679-1988 Owner(s) of the Property as recorded in Town Land Records Address of Owner(s) Property Offered (Street Address, Town) Zoning Lot Size Frontage (feet) Accessibility to Public Transportation Topography of Site Flood Zone and Other Limiting Conditions Parking Offered Owned On-site Parking Garage Levels Total Spaces Provided
Not Owned
Off Site
Off Site Location
Building Offered: Rental Office Industrial Other Year Built
Year Renovated
Describe What Renovated
Complies with ADA?
Other Codes?
Type of Structure (e.g.Steel) Exterior Walls (e.g.Brick) No. Stories
Type of Roof Cover (e.g.shingles) Age of Roof Sprinkler System: Wet Dry None
Number of Elevators: Passenger Freight Load Capacity of Floors PPSF
Security System (e.g. electronic, personnel): Describe
Heating System: Type No. Zones Fuel Age (yrs) When updated
Air Conditioning (if applicable): Type No. Zones Fuel Age
Total Bldg. Gross Sq.Ft.(GSF) Total Bldg. Net Usable Sq.Ft.(NUSF) Total NUSF per floor (Note: See below for definition of Net Usable Square Feet.) Amount of Space Available for Lease: 1) NUSF on the Floor 2) NUSF on the floor 3) NUSF on the Floor 4) NUSF on the Floor 5) NUSF on the floor Definition of Net Usable Square Feet: The interior floor area of a building, used for office and other purposes, within the area leased by a tenant which is for its exclusive use: any space shared in common with other tenants, such as, entrance and elevator lobbies; hallways, bathrooms, or used by management for other tenants, such as janitorial or electronic/mechanical closets, is not part of net usable area: if these areas are for the sole use of a tenant, they may be counted in that tenant’s net usable area. The measurement includes structural elements of the building found in the tenant’s space, such as columns and projections necessary to the building but excludes vertical space penetrations of the building such as elevators, stairwells, air shafts and stacks. Measurement of net usable space is to the dominant (over 50%) inside face, such as window glass of the exterior wall; to the midpoint of a wall separating a tenant from an adjacent tenant; and to the inside face of a common corridor, elevator shaft, stairway or similar space.
PROPOSAL TO LEASE SPACE FCL-0080-8 – PAGE 2 Proposal: 1. TENANT IMPROVEMENTS: Standard allowance for tenant improvements included in Base Rent $ per NUSF 2. BASE RENT before tenant improvements but including standard allowance $ Per NUSF per year 3. OPERATING EXPENSES: Who pays for operating expenses?
Check One If Lessee, Estimated Expense Lessor Lessee Cost per Sq. Ft.
Real Estate Taxes
Insurance
Heat
Electricity
Air Conditioning
Hot Water
Cold Water
Janitor Services, Premises
Janitor Services, Common Area
Window Washing, in/out
Landscaping
Snow & Ice Removal
Rubbish Removal
Replacement of burnt-out Ballasts, Tubes & Bulbs
Other Maintenance/Repairs
Pest Control
Security System (see above)
Parking
4. Total Base Rent and Operating Expenses paid by Lessee
Other Conditions (such as date space will be available)
Attach the following to this proposal
1. Recent photograph of property 3. Typical floor plan
2. Map of neighborhood showing location of building 4. Flyer or brochure, if available
CERTIFICATE
I, the undersigned, hereby certify that I am an owner or agent of record for an owner of the property which is being offered in this proposal and that the statements made by me on this proposal are complete and true to the best of my knowledge and are made in good faith. I understand that if I knowingly make any misstatement of fact, I am subject to disqualification and other penalty imposed by law. (Note: Read this proposal and your answers carefully before signing.) Only signed proposals will be considered. If you are a real estate agent, please include a “Notice of Listing Agreement” authorizing you to present this property. By statute, the State of Connecticut will deal only with owners or their authorized agents. Responses from option holders cannot be considered. SIGNED DATE
NOTICE OF LISTING AGREEMENT FCL-0080-8
RETURN TO: UNIVERSITY OF CONNECTICUT HEALTH CENTER
OFFICE OF FACILITY CONTRACTS & LEASES 263 FARMINGTON AVENUE, FARMINGTON, CT 06030-4039
__________________, 20__
INSTRUCTIONS This form is to be submitted when an agent has been authorized by the owner(s). The State of Connecticut, by statute, will deal only with owners or their authorized agents. OPTION HOLDERS CANNOT BE CONSIDERED. PARTIES AND PROPERTY I/We [Owner(s)] ____________________________________________________________, give
[agent(s)] _________________________________________________ the right to lease my/our
property located at (listed property) _____________________________________________, CT.
Solicitation No. FCL-0080-8 Date/Time due back: September 25, 2009 at 3:30 PM
OWNER(S) AND AGENT(S) AGREEMENT:
The parties agree that:
This agreement will go into effect on ________________________________________, 20____
and will remain effective through and including ______________________________, 20____.
SPECIAL INFORMATION: (any restrictions, special conditions specific to proposal).
STATEMENTS REQUIRED BY LAW I, the undersigned, hereby certify that I am an agent of record for the owner(s) of the property which is being offered in the proposal.
By:
Authorized representative(s):
Number and Street:
City, State, Zip:
Date:
Owner(s):
Number and Street:
City, State, Zip:
Date:
[
COMMISSION ON HUMAN RIGHTS AND OPPORTUNITIES CONTRACT COMPLIANCE REGULATIONS NOTIFICATION TO BIDDERS
The contract to be awarded is subject to contract compliance requirements mandated by Sections 4a‐60 and 4a‐60a of the Connecticut General Statutes; and, when the awarding agency is the State, Sections 46a‐71(d) and 46a‐81i(d) of the Connecticut General Statutes. There are Contract Compliance Regulations codified at Section 46a‐68j‐21 through 43 of the Regulations of Connecticut State Agencies, which establish a procedure for awarding all contracts covered by Sections 4a‐60 and 46a‐71(d) of the Connecticut General Statutes.
According to Section 46a‐68j‐30(9) of the Contract Compliance Regulations, every agency awarding a contract subject to the contract compliance requirements has an obligation to “aggressively solicit the participation of legitimate minority business enterprises as bidders, contractors, subcontractors and suppliers of materials.” “Minority business enterprise” is defined in Section 4a‐60 of the Connecticut General Statutes as a business wherein fifty‐one percent or more of the capital stock, or assets belong to a person or persons: “(1) Who are active in daily affairs of the enterprise; (2) who have the power to direct the management and policies of the enterprise; and (3) who are members of a minority, as such term is defined in subsection (a) of Section 32‐9n.” “Minority” groups are defined in Section 32‐9n of the Connecticut General Statutes as “(1) Black Americans . . . (2) Hispanic Americans . . . (3) persons who have origins in the Iberian Peninsula . . . (4)Women . . . (5) Asian Pacific Americans and Pacific Islanders; (6) American Indians . . .” An individual with a disability is also a minority business enterprise as provided by Section 4a‐60g of the Connecticut General Statutes. The above definitions apply to the contract compliance requirements by virtue of Section 46a‐68j‐21(11) of the Contract Compliance Regulations.
The awarding agency will consider the following factors when reviewing the bidder’s qualifications under the contract compliance requirements:
(a) the bidder’s success in implementing an affirmative action plan; (b) the bidder’s success in developing an apprenticeship program complying with Sections 46a‐68‐1 to 46a‐
68‐17 of the Administrative Regulations of Connecticut State Agencies, inclusive; (c) the bidder’s promise to develop and implement a successful affirmative action plan; (d) the bidder’s submission of employment statistics contained in the “Employment Information Form”,
indicating that the composition of its workforce is at or near parity when compared to the racial and sexual composition of the workforce in the relevant labor market area; and
(e) the bidder’s promise to set aside a portion of the contract for legitimate minority business enterprises. See Section 46a‐68j‐30(10)(E) of the Contract Compliance Regulations.
INSTRUCTIONS AND OTHER INFORMATION
The following BIDDER CONTRACT COMPLIANCE MONITORING REPORT must be completed in full, signed, and submitted with the bid for this contract. The contract awarding agency and the Commission on Human Rights and Opportunities will use the information contained thereon to determine the bidders compliance to Sections 4a‐60 and 4a‐60a CONN. GEN. STAT., and Sections 46a‐68j‐23 of the Regulations of Connecticut State Agencies regarding equal employment opportunity, and the bidder’s good faith efforts to include minority business enterprises as subcontractors and suppliers for the work of the contract.
1) Definition of Small and Minority‐Owned Contractor Section 4a‐60g CONN. GEN. STAT. defines a small contractor as a company that has been doing business under the same management and control and has maintained its principal place of business in Connecticut for a one year period immediately prior to its application for certification under this section, had gross revenues not exceeding ten million dollars in the most recently completed fiscal year, and at least fifty‐one percent of the ownership of which is held by a person or persons who are active in the daily affairs of the company, and have the power to direct the management and policies of the company, except that a nonprofit corporation shall be construed to be a small contractor if such nonprofit corporation meets the requirements of subparagraphs (A) and (B) of subdivision 4a‐60g CONN. GEN. STAT.
INVITATION TO SUBMIT LEASE PROPOSAL S T A T E OF CONNEC T I CU T
UNIVERSITY OF CONNECTICUT HEALTH CENTER
Jennifer K. Kelley FACILITY CONTRACTS & LEASES
SOLICITATION
FCL‐0080‐8
Purchasing Services Officer 263 Farmington Avenue, MC 4039
860‐679‐1988 Farmington, CT 06032
Telephone Number
Read & Complete
Carefully
[
2) Description of Job Categories (as used in Part IV Proposer Employment Information)
MANAGEMENT: Managers plan, organize, direct, and control the major functions of an organization through subordinates who are at the managerial or supervisory level. They make policy decisions and set objectives for the company or departments. They are not usually directly involved in production or providing services. Examples include top executives, public relations managers, managers of operations specialties (such as financial, human resources, or purchasing managers), and construction and engineering managers. BUSINESS AND FINANCIAL OPERATIONS: These occupations include managers and professionals who work with the financial aspects of the business. These occupations include accountants and auditors, purchasing agents, management analysts, labor relations specialists, and budget, credit, and financial analysts. MARKETING AND SALES: Occupations related to the act or process of buying and selling products and/or services such as sales engineer, retail sales workers and sales representatives including wholesale. LEGAL OCCUPATIONS: In‐House Counsel who is charged with providing legal advice and services in regards to legal issues that may arise during the course of standard business practices. This category also includes assistive legal occupations such as paralegals, legal assistants. COMPUTER SPECIALISTS: Professionals responsible for the computer operations within a company are grouped in this category. Examples of job titles in this category include computer programmers, software engineers, database administrators, computer scientists, systems analysts, and computer support specialists ARCHITECTURE AND ENGINEERING: Occupations related to architecture, surveying, engineering, and drafting are included in this category. Some of the job titles in this category include electrical and electronic engineers, surveyors, architects, drafters, mechanical engineers, materials engineers, mapping technicians, and civil engineers. OFFICE AND ADMINISTRATIVE SUPPORT: All clerical‐type work is included in this category. These jobs involve the preparing, transcribing, and preserving of written communications and records; collecting accounts; gathering and distributing information; operating office machines and electronic data processing equipment; and distributing mail. Job titles listed in this category include telephone operators, bill and account collectors, customer service representatives, dispatchers, secretaries and administrative assistants, computer operators and clerks (such as payroll, shipping, stock, mail and file).
BUILDING AND GROUNDS CLEANING AND MAINTENANCE: This category includes occupations involving landscaping, housekeeping, and janitorial services. Job titles found in this category include supervisors of landscaping or housekeeping, janitors, maids, grounds maintenance workers, and pest control workers. CONSTRUCTION AND EXTRACTION: This category includes construction trades and related occupations. Job titles found in this category include boilermakers, masons (all types), carpenters, construction laborers, electricians, plumbers (and related trades), roofers, sheet metal workers, elevator installers, hazardous materials removal workers, paperhangers, and painters. Paving, surfacing, and tamping equipment operators; drywall and ceiling tile installers; and carpet, floor and tile installers and finishers are also included in this category. First line supervisors, foremen, and helpers in these trades are also grouped in this category.. INSTALLATION, MAINTENANCE AND REPAIR: Occupations involving the installation, maintenance, and repair of equipment are included in this group. Examples of job titles found here are heating, ac, and refrigeration mechanics and installers; telecommunication line installers and repairers; heavy vehicle and mobile equipment service technicians and mechanics; small engine mechanics; security and fire alarm systems installers; electric/electronic repair, industrial, utility and transportation equipment; millwrights; riggers; and manufactured building and mobile home installers. First line supervisors, foremen, and helpers for these jobs are also included in the category. MATERIAL MOVING WORKERS: The job titles included in this group are Crane and tower operators; dredge, excavating, and lading machine operators; hoist and winch operators; industrial truck and tractor operators; cleaners of vehicles and equipment; laborers and freight, stock, and material movers, hand; machine feeders and offbearers; packers and packagers, hand; pumping station operators; refuse and recyclable material collectors; and miscellaneous material moving workers.
PRODUCTION WORKERS: The job titles included in this category are chemical production machine setters, operators and tenders; crushing/grinding workers; cutting workers; inspectors, testers sorters, samplers, weighers; precious stone/metal workers; painting workers; cementing/gluing machine operators and tenders; etchers/engravers; molders, shapers and casters except for metal and plastic; and production workers.
3) Definition of Racial and Ethnic Terms (as used in Part IV Proposer Employment Information) White (not of Hispanic Origin)‐ All persons having origins in any of the original peoples of Europe, North Africa, or the Middle East. Black (not of Hispanic Origin)‐ All persons having origins in any of the Black racial groups of Africa. Hispanic‐ All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
Asian or Pacific Islander‐ All persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands. This area includes China, India, Japan, Korea, the Philippine Islands, and Samoa. American Indian or Alaskan Native‐ All persons having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition.
[
CONTRACT COMPLIANCE MONITORING REPORT
PART I – Proposer Information SOLICITATION FCL‐00080‐08 Company Name: Street Address: City & State: Chief Executive:
Bidder Federal Employer Identification Number: Or Social Security Number:
Major Business Activity (brief description)
Bidder Identification (response optional/definitions on page 1) ‐Bidder is a small contractor: Yes No ‐Bidder is a minority business enterprise: Yes No (If yes, check ownership category)
Black Hispanic Asian American
American Indian/Alaskan Native Iberian Peninsula Individual(s) with a Physical Disability: Female:
Bidder Parent Company (If any)
‐ Bidder is certified as above by State of CT Yes No
Other Locations in Ct. (If any)
‐ DAS Certification Number:
PART II ‐ Bidder Nondiscrimination Policies and Procedures 1. Does your company have a written Affirmative Action/Equal Employment Opportunity statement posted on company bulletin boards?
Yes No
7. Do all of your company contracts and purchase orders contain non‐discrimination statements as required by Sections 4a‐60 & 4a‐60a Conn. Gen. Stat.?
Yes No 2. Does your company have the state‐mandated sexual harassment prevention in the workplace policy posted on company bulletin boards?
Yes No
8. Do you, upon request, provide reasonable accommodation to employees, or applicants for employment, who have physical or mental disability?
Yes No 3. Do you notify all recruitment sources in writing of your company’s Affirmative Action/Equal Employment Opportunity employment policy
Yes No
9. Does your company have a mandatory retirement age for all employees?
Yes No 4. Do your company advertisements contain a written statement that you are an Affirmative Action/Equal Opportunity Employer?
Yes No
10. If your company has 50 or more employees, have you provided at least two (2) hours of sexual harassment training to all of your supervisors?
Yes No NA 5. Do you notify the Ct. State Employment Service of all employment openings with your company?
Yes No
11. If your company has apprenticeship programs, do they meet the Affirmative Action/Equal Employment Opportunity requirements of the apprenticeship standards of the Ct. Dept. of Labor?
Yes No NA 12. Does your company have a written affirmative action Plan?
Yes No
If no, please explain.
6. Does your company have a collective bargaining agreement with workers?
Yes No 6a. If yes, do the collective bargaining agreements contain non‐discrimination clauses covering all workers?
Yes No 6b. Have you notified each union in writing of your commitments under the nondiscrimination requirements of contracts with the state of Ct?
Yes No
13. Is there a person in your company who is responsible for equal employment opportunity?
Yes No If yes, give name and phone number. ____________________________________________________ _____________________________________________________
Part III ‐ Bidder Subcontracting Practices 1. Will the work of this contract include subcontractors or suppliers? Yes No 1a. If yes, please list all subcontractors and suppliers and report if they are a small contractor and/or a minority business enterprise. (defined on page 1 / use additional sheet if necessary)
1b. Will the work of this contract require additional subcontractors or suppliers other than those identified in 1a. above? Yes No
[
PART IV ‐ Proposer Employment Information Date: SOLICITATION FCL‐00080‐08
JOB CATEGORY *
OVERALL TOTALS
WHITE
(not of Hispanic origin)
BLACK
(not of Hispanic origin)
HISPANIC
ASIAN or PACIFIC
ISLANDER
AMERICAN INDIAN or ALASKAN NATIVE
Male
Female
Male
Female
Male
Female
Male
Female
male
Female
Management
Business & Financial Ops
Marketing & Sales
Legal Occupations
Computer Specialists
Architecture/Engineering
Office & Admin Support
Bldg/ Grounds Cleaning/Maintenance
Construction & Extraction
Installation , Maintenance
& Repair
Material Moving Workers
Production Occupations
TOTALS ABOVE
Total One Year Ago
FORMAL ON THE JOB TRAINEES (ENTER FIGURES FOR THE SAME CATEGORIES AS ARE SHOWN ABOVE)
Apprentices
Trainees
*NOTE: JOB CATEGORIES CAN BE CHANGED OR ADDED TO (EX. SALES CAN BE ADDED OR REPLACE A CATEGORY NOT USED IN YOUR COMPANY) PART V ‐ Proposer Hiring and Recruitment Practices
1. Which of the following recruitment sources are used by you? (Check yes or no, and report percent used)
2. Check (X) any of the below listed requirements that you use as a hiring qualification (X)
3. Describe below any other practices or actions that you take which show that you hire, train, and promote employees without discrimination
SOURCE
YES
NO
% of applicants provided by source
State Employment Service
Work Experience
Private Employment Agencies
Ability to Speak or Write English
Schools and Colleges
Written Tests
Newspaper Advertisement
High School Diploma
Walk Ins
College Degree
Present Employees
Union Membership
Labor Organizations
Personal Recommendation
Minority/Community Organizations
Height or Weight
Others (please identify)
Car Ownership
Arrest Record
Wage Garnishments
Certification: (Read this form and check your statements on it CAREFULLY before signing). I certify that the statements made by me on this BIDDER CONTRACT COMPLIANCE MONITORING REPORT are complete and true to the best of my knowledge and belief, and are made in good faith. I understand that if I knowingly make any misstatements of facts, I am subject to be declared in non‐compliance with Section 4a‐60, 4a‐60a, and related sections of the CONN. GEN. STAT. (Signature)
(Title)
(Date Signed) (Telephone)
INVITATION TO SUBMIT LEASE PROPOSAL STATE OF CONNECTICUT Solicitation Number:
UNIVERSITY OF CONNECTICUT HEALTH CENTER FACILITY CONTRACTS & LEASES FCL‐0080‐8
Jennifer K. Kelley 263 Farmington Avenue, MC 4039
Purchasing Services Officer Farmington, CT 06032 860‐679‐1988 Telephone Number
State of Connecticut
Contract Affidavits, Certifications, and Notices
CONTRACTING AFFIDAVITS/CERTIFICATION FORMS
Signed by CONTRACTOR WHEN TO SUBMIT
Signed by AGENCY
ALL Contracts cost or value ≥ over $0.00
All Contracts Cost or value
≥ $50K
All Contracts Cost or value
≥ $500K
submit form with
bid or proposal
NONDISCRIMINATION FORM
(Individual or Contractor)
FORM 5* FORM 6 **
submit form at time of
contract execution FORM 3
NONDISCRIMINATION FORM
(Individual or Contractor)
FORM 1 FORM 5*
FORM 6 **
submit form after
contract execution
FORM 6 **
submit form annually if
multi‐year contract
FORM 1
* Form 5 is normally submitted by the contractor to the awarding State agency with the bid or proposal. However, for a sole
source or no bid contract, it is submitted at the time of contract execution. ** Form 6 is normally submitted by the contractor to the awarding State agency with the bid or proposal. However, for a sole
source or no bid contract, Form 6 is submitted at the time of contract execution. When applicable, Form 6 is also used by a subcontractor or consultant of the contractor. The subcontractor or consultant submits the form to the contractor, who then submits it to the awarding State agency. Depending on when the contractor engages the subcontractor or consultant, the contractor either submits the form at the time of contract execution or after contract execution.
For Further Information, Contact:
Please direct any questions about the ethics forms to Wanda Dupuy, (860) 418‐6261, [email protected]. Form 1‐ Gift and Campaign Contribution Certification This certification accompanies a State contract with a value of $50,000 or more in a calendar or fiscal year. The completed form is submitted by the contractor to the awarding State agency at the time of contract execution. The form is also used with a multi‐year contract to update the initial certification on an annual basis. Form 3‐ Certification of State Agency Official or Employee Authorized to Execute Contract This certification accompanies a State contract with a value of $50,000 or more in a calendar or fiscal year. The completed form is
signed at the time of contract execution by the State agency official or employee authorized to execute the contract on behalf of the awarding State agency. Form 5‐ Consulting Agreement Affidavit This affidavit accompanies a State contract for the purchase of goods or services with a value of $50,000 or more in a calendar or fiscal year. Form 5 is normally submitted by the contractor to the awarding State agency with the bid or proposal. However, for a sole source or no bid contract, it is submitted at the time of contract execution. Form 6‐ Affirmation of Receipt of State Ethics Laws Summary This affirmation accompanies a large State construction contract or a large State procurement contract with a cost of more than $500,000. Form 6 is normally submitted by the contractor to the awarding State agency with the bid or proposal. However, for a sole source or no bid contract, Form 6 is submitted at the time of contract execution. When applicable, Form 6 is also used by a subcontractor or consultant of the contractor. The subcontractor or consultant submits the form to the contractor, who then submits it to the awarding State agency. PLAIN LANGUAGE SUMMARY OF STATE ETHICS LAWS FOR CURRENT AND POTENTIAL STATE CONTRACTORS Note: The following is a summary of the major ethics laws and related provisions applicable to current and potential state contractors. For more detailed information or to discuss any questions you may have, contact the Office of State Ethics at (860) 566‐4472.
I. RESTRICTIONS ON THE BENEFITS YOU MAY GIVE TO STATE PERSONNEL GIFTS: In general, no one doing business with or seeking business from a state or quasi‐public agency may give a gift to an official or employee of that agency. Connecticut’s gift ban is strict, but has some exceptions. For example, under the Ethics Code, you may give: (1) food and drink up to $50 per person per year, if the person paying, or his or her representative, is in attendance; and (2) tangible gifts up to $10 per item up to $50 per person per year. Also exempt are certain items such as informational materials, or plaques costing less than $100. For a complete list of the Code’s gift exceptions, consult Conn. Gen. Stat. § 1‐79(e) or contact the Office of State Ethics. IMPORTANT RECENT CHANGE IN LAW: As of August 19, 2004, gifts for “major life events,” including a wedding or the birth of a child, which were previously exempt from the gift ban, are now subject to the strict gift limits outlined above if the gifts are provided by any individual or entity doing business with or seeking business from the state. NOTE: State agencies may have stricter gift rules than the provisions of the Ethics Code (for example, an agency policy may ban all food and drink). Be sure to obtain a copy of the agency’s ethics policy before you provide any benefit to an agency official/employee. NECESSARY EXPENSES: Under the Ethics Code, you may not pay a fee or an honorarium to a state official or employee for making a speech or appearing at your organization’s event. You may, however, under limited circumstances, pay the “necessary expenses” of such a state servant. These expenses are limited to: necessary travel, lodging for the nights before, or and after the speech, meals and conference fees. There may be reporting requirements attached to the giving and taking of necessary expenses, so contact the Office of State Ethics if you need more information. NOTE: Before providing necessary expenses, check with the state agency’s ethics officer to determine if the agency allows such payments. GIFTS TO THE STATE: The Ethics Code allows limited “gifts to the state” which facilitate state action or functions (for example, donating a piece of equipment to the agency). NOTE: Recent legislation was passed that may impact gifts to the state. Please contact the Office of State Ethics before giving a gift to the state to determine if such donations are acceptable.
II. RULES ON HIRING STATE PERSONNEL Before you hire a current or former state employee, you should be aware of certain provisions of the Ethics Code. First, if you are considering hiring a current state employee, especially from a state agency with which you do business or by which you are regulated, you should know the following: A current state employee must not accept outside employment that impairs his independence of judgment regarding his state duties, or that encourages him to disclose confidential information learned in his state job. Also, a current state employee may not use his or her state position for financial gain, however inadvertent that use may be. Therefore, for example, a current state employee who exercises any contractual, supervisory or regulatory authority over you or your business may not be able to work for you. Second, if you are considering hiring a former state employee, you should be aware of the Ethics Code’s post‐state employment, or revolving door, laws: If you hire or otherwise engage the services of a former state official or employee, he or she may not represent you before his of her former agency for one year after leaving state service.
NOTE: The former State Ethics Commission established a limited exception to this provision which allows the former employee to return to his or her former agency within the one year period for the sole purpose of providing technical expertise (for example, to help implement a previously awarded contract). This is a fact‐specific exception that applies in very limited circumstances: therefore, you should contact the Office of State Ethics for further assistance if you think this exception applies to you. If a state official or employee was substantially involved in, or supervised, the negotiation or award of a contract valued at $50,000 or more, and the contract was signed within his or her last year of state service, and you or your business was one of the parties to the contract, then you and/or your business are prohibited from hiring him or her for one year after he or she leaves state employment. A former state official or employee can never represent anyone other than the state regarding a particular matter in which he or she was personally and substantially involved while in state service and in which the state has a substantial interest. Third, there are approximately 75 state officials or employees who may not negotiate for, seek or accept employment with any business subject to regulation by their agency, and may not accept employment with such a business for one year after leaving state service. Under that section of the law, it is also illegal for a business in the industry to employ such an individual.
III. CONFLICT OF INTEREST RULES THAT APPLY TO YOU AS A STATE CONTRACTOR Under Conn. Gen. Stat. §1‐86e of the Ethics Code, no state contractor, including a consultant or other independent contractor, can use the authority provided under the contract, or confidential information acquired in the performance of the contract, to obtain financial gain for himself, his employee, or a member of his immediate family. Also, a state contractor cannot accept another state contract that would impair his independence of judgment in the performance of the first contract. Finally, a state contractor cannot accept anything of value based on an understanding that his actions on behalf of the state would be influenced. It is important to call the Office of State Ethics at (860) 566‐4472 to discuss the application of this law, or any of the other ethics laws, to your specific situation.
IV. OTHER ETHICS PROVISIONS THAT MAY APPLY TO YOU Contractors seeking large state contracts are required to execute affidavits regarding gifts and/or campaign contributions made to certain state employees or public officials in the two‐year period prior to the submission of a bid or proposal. You need to check the web sites of both the Department of Administrative Services, www.das.state.ct.us , and the Office of Policy and Management, www.opm.state.ct.us , for copies of these affidavits and for other updated information regarding state contractors. Also, because the particular agency with which you wish to contract may have specific rules that you must follow, you need to check with that agency as well. If you or your business provides “investment services” as defined in the Code of Ethics, and you make a political contribution in connection with the Office of the Treasurer, you may be prohibited from contracting with that office. See Conn. Gen. Stat. § 1‐84(n). Finally, if you or your business spends or receives $2,000 or more in a calendar year for activities that constitute lobbying under the Ethics Code, whether to affect legislation or the actions of an administrative state agency, then you and/or your business may have to register as a lobbyist with the Office of State Ethics, and more ethics rules will apply to you. Contact the Office of State Ethics, or review the lobbyist registration information at www.ct.gov/ethics. Recent legislation (Public Act 05‐287) prohibits anyone who is a party (or who is seeking to become a party) to a state construction, procurement, or consultant services contract over $500,000 from: (1) Soliciting information from a public official or state employee that is not available to other bidders for that contract, with the intent to obtain a competitive advantage over other bidders; (2) intentionally or recklessly charging a state agency for work not performed or goods or services not provided, or falsifying invoices or bills; or (3) intentionally violating or trying to circumvent the state competitive bidding and ethics laws. Recent legislation (Public Act 05‐287) also requires any prospective state contractor to affirm in writing that he or she has been provided with a summary of the state’s ethics laws and that his key employees have read and understood the summary and agree to comply with the applicable provisions of the ethics law.
FORM 11 Campaign Contribution and Solicitation Ban No state contractor, prospective state contractor, principal of a state contractor or principal of a prospective state contractor, with regard to a state contract or state contract solicitation with or from a state agency in the executive branch or a quasi‐public agency or a holder, or principal of a holder of a valid prequalification certificate, shall make a contribution to, or solicit contributions on behalf of (i) an exploratory committee or candidate committee established by a candidate for nomination or election to the office of Governor, Lieutenant Governor, Attorney General, State Comptroller, Secretary of the State or State Treasurer, (ii) a political committee authorized to make contributions or expenditures to or for the benefit of such candidates, or (iii) a party committee;
In addition, no holder or principal of a holder of a valid prequalification certificate, shall make a contribution to, or solicit contributions on behalf of (i) an exploratory committee or candidate committee established by a candidate for nomination or election to the office of State senator or State representative, (ii) a political committee authorized to make contributions or expenditures to or for the benefit of such candidates, or (iii) a party committee.
Nondiscrimination Certification (AG Form) The Office of the Attorney General created a nondiscrimination certification form (attached) to assist State agencies in complying with the State of Connecticut's current contracting requirement, pursuant to the Connecticut General Statutes § 4a‐60(a)(1) and § 4a‐60a(a)(1), as amended by Public Act 07‐245 and Section 9(a)(1) and 10(a)(1) of Public Act 07‐142. This certification is required for all State contracts, regardless of type, term, cost, or value. The revised CGS 4a‐60 and 40‐60a are included in their entirety below. Sec. 4a‐60. (Formerly Sec. 4‐114a). Nondiscrimination and affirmative action provisions in contracts of the state and political subdivisions other than municipalities.
(a) Every contract to which the state or any political subdivision of the state other than a municipality is a party shall contain the following provisions: (1) The contractor agrees and warrants that in the performance of the contract such contractor will not discriminate or permit discrimination against any person or group of persons on the grounds of race, color, religious creed, age, marital status, national origin, ancestry, sex, mental retardation or physical disability, including, but not limited to, blindness, unless it is shown by such contractor that such disability prevents performance of the work involved, in any manner prohibited by the laws of the United States or of the state of Connecticut. The contractor further agrees to take affirmative action to insure that applicants with job‐related qualifications are employed and that employees are treated when employed without regard to their race, color, religious creed, age, marital status, national origin, ancestry, sex, mental retardation, or physical disability, including, but not limited to, blindness, unless it is shown by such contractor that such disability prevents performance of the work involved; (2) the contractor agrees, in all solicitations or advertisements for employees placed by or on behalf of the contractor, to state that it is an "affirmative action‐equal opportunity employer" in accordance with regulations adopted by the commission; (3) the contractor agrees to provide each labor union or representative of workers with which such contractor has a collective bargaining agreement or other contract or understanding and each vendor with which such contractor has a contract or understanding, a notice to be provided by the commission advising the labor union or workers' representative of the contractor's commitments under this section, and to post copies of the notice in conspicuous places available to employees and applicants for employment; (4) the contractor agrees to comply with each provision of this section and sections 46a‐68e and 46a‐68f and with each regulation or relevant order issued by said commission pursuant to sections 46a‐56, as amended by this act, 46a‐68e and 46a‐68f; (5) the contractor agrees to provide the Commission on Human Rights and Opportunities with such information requested by the commission, and permit access to pertinent books, records and accounts, concerning the employment practices and procedures of the contractor as relate to the provisions of this section and section 46a‐56, as amended by this act. If the contract is a public works contract, the contractor agrees and warrants that he will make good faith efforts to employ minority business enterprises as subcontractors and suppliers of materials on such public works project. Prior to entering into the contract, the contractor shall provide the state or such political subdivision of the state with documentation in the form of a company or corporate policy adopted by resolution of the board of directors, shareholders, managers, members or other governing body of such contractor to support the nondiscrimination agreement and warranty under subdivision (1) of this subsection. For the purposes of this section, "contract" includes any extension or modification of the contract, and "contractor" includes any successors or assigns of the contractor.
(b) For the purposes of this section, "minority business enterprise" means any small contractor or supplier of materials fifty‐one per cent or more of the capital stock, if any, or assets of which is owned by a person or persons: (1) Who are active in the daily affairs of the enterprise, (2) who have the power to direct the management and policies of the enterprise and (3) who are members of a minority, as such term is defined in subsection (a) of section 32‐9n; and "good faith" means that degree of diligence which a reasonable person would exercise in the performance of legal duties and obligations. "Good faith efforts" shall include, but not be limited to, those reasonable initial efforts necessary to comply with statutory or regulatory requirements and additional or substituted efforts when it is determined that such initial efforts will not be sufficient to comply with such requirements.
Sec. 4a‐60a. Contracts of the state and political subdivisions, other than municipalities, to contain provisions re nondiscrimination on the basis of sexual orientation.
a) Every contract to which the state or any political subdivision of the state other than a municipality is a party shall contain the following provisions: (1) The contractor agrees and warrants that in the performance of the contract such contractor will not discriminate or permit discrimination against any person or group of persons on the grounds of sexual orientation, in any manner prohibited by the laws of the United States or of the state of Connecticut, and that employees are treated when employed without regard to their sexual orientation; (2) the contractor agrees to provide each labor union or representative of workers with which such contractor has a collective bargaining agreement or other contract or understanding and each vendor with which such contractor has a contract or understanding, a notice to be provided by the Commission on Human Rights and Opportunities advising the labor union or workers' representative of the contractor's commitments under this section, and to post copies of the notice in conspicuous places available to employees and applicants for employment; (3) the contractor agrees to comply with each provision of this section and with each regulation or relevant order issued by said commission pursuant to section 46a‐56, as amended by this act; (4) the contractor agrees to provide the Commission on Human Rights and Opportunities with such information requested by the commission, and permit access to pertinent books, records and accounts, concerning the employment practices and procedures of the contractor which relate to the provisions of this section and section 46a‐56, as amended by this act. Prior to entering into the contract, the contractor shall provide the state or such political subdivision of the state with documentation in the form of a company or corporate policy adopted by resolution of the board of directors, shareholders, managers, members or other governing body of such contractor to support the nondiscrimination agreement and warranty under subdivision (1) of this subsection. For the purposes of this section, "contract" includes any extension or modification of the contract, and "contractor" includes any successors or assigns of the contractor.
(b) The contractor shall include the provisions of subsection (a) of this section in every subcontract or purchase order entered
into in order to fulfill any obligation of a contract with the state and such provisions shall be binding on a subcontractor, vendor or manufacturer unless exempted by regulations or orders of the commission. The contractor shall take such action with respect to any such subcontract or purchase order as the commission may direct as a means of enforcing such provisions including sanctions for noncompliance in accordance with section 46a‐56; provided, if such contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the commission, the contractor may request the state of Connecticut to enter into any such litigation or negotiation prior thereto to protect the interests of the state and the state may so enter.
OPM Ethics Form 1 Rev. 10-31-07 Page 1 of 2
STATE OF CONNECTICUT GIFT AND CAMPAIGN CONTRIBUTION CERTIFICATION Solicitation FCL‐0080‐8
Certification to accompany a State contract with a value of $50,000 or more in a calendar or fiscal year, pursuant to C.G.S. §§ 4‐250 and 4‐252(c); Governor M. Jodi Rell’s Executive Orders No. 1, Para. 8, and No. 7C, Para. 10; and C.G.S. §9‐612(g)(2), as amended by Public Act 07‐1
INSTRUCTIONS: Complete all sections of the form. Attach additional pages, if necessary, to provide full disclosure about any lawful campaign contributions made to campaigns of candidates for statewide public office or the General Assembly, as described herein. Sign and date the form, under oath, in the presence of a Commissioner of the Superior Court or Notary Public. Submit the completed form to the awarding State agency at the time of initial contract execution (and on each anniversary date of a multi‐year contract, if applicable). CHECK ONE: Initial Certification Annual Update (Multi‐year contracts only.) GIFT CERTIFICATION: As used in this certification, the following terms have the meaning set forth below: 1) “Contract” means that contract between the State of Connecticut (and/or one or more of it agencies or instrumentalities) and the
Contractor, attached hereto, or as otherwise described by the awarding State agency below; 2) If this is an Initial Certification, “Execution Date” means the date the Contract is fully executed by, and becomes effective
between, the parties; if this is an Annual Update, “Execution Date” means the date this certification is signed by the Contractor; 3) “Contractor” means the person, firm or corporation named as the contactor below; 4) “Applicable Public Official or State Employee” means any public official or state employee described in C.G.S. §4‐252(c)(1)(i) or (ii); 5) “Gift” has the same meaning given that term in C.G.S. § 4‐250(1); 6) “Planning Start Date” is the date the State agency began planning the project, services, procurement, lease or licensing
arrangement covered by this Contract, as indicated by the awarding State agency below; and 7) “Principals or Key Personnel” means and refers to those principals and key personnel of the Contractor, and its or their agents, as
described in C.G.S. §§ 4‐250(5) and 4‐252(c)(1)(B) and (C).
I, the undersigned, am the official authorized to execute the Contract on behalf of the Contractor. I hereby certify that, between the Planning Start Date and Execution Date, neither the Contractor nor any Principals or Key Personnel has made, will make (or has promised, or offered, to, or otherwise indicated that he, she or it will, make) any Gifts to any Applicable Public Official or State Employee. I further certify that no Principals or Key Personnel know of any action by the Contractor to circumvent (or which would result in the circumvention of) the above certification regarding Gifts by providing for any other principals, key personnel, officials, or employees of the Contractor, or its or their agents, to make a Gift to any Applicable Public Official or State Employee. I further certify that the Contractor made the bid or proposal for the Contract without fraud or collusion with any person. CAMPAIGN CONTRIBUTION CERTIFICATION: I further certify that, on or after December 31, 2006, neither the Contractor nor any of its principals, as defined in C.G.S. § 9‐612(g)(1), has made any campaign contributions to, or solicited any contributions on behalf of, any exploratory committee, candidate committee, political committee, or party committee established by, or supporting or authorized to support, any candidate for statewide public office, in violation of C.G.S. § 9‐612(g)(2)(A). I further certify that all lawful campaign contributions that have been made on or after December 31, 2006 by the Contractor or any of its principals, as defined in C.G.S. § 9‐612(g)(1), to, or solicited on behalf of, any exploratory committee, candidate committee, political committee, or party committee established by, or supporting or authorized to support any candidates for statewide public office or the General Assembly, are listed below:
OPM Ethics Form 1 Rev. 10-31-07
STATE OF CONNECTICUT GIFT AND CAMPAIGN CONTRIBUTION CERTIFICATION
Lawful Campaign Contributions to Candidates for Statewide Public Office: Contribution Date Name of Contributor Recipient Value Description
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______________________________________________________________________________________ Lawful Campaign Contributions to Candidates for the General Assembly: Contribution Date Name of Contributor Recipient Value Description
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______________________________________________________________________________________ Sworn as true to the best of my knowledge and belief, subject to the penalties of false statement. ______________________________ _________________________________________ Printed Contractor Name Signature of Authorized Official Subscribed and acknowledged before me this ______ day of __________________, 200__.
___________________________________________ Commissioner of the Superior Court (or Notary Public)
For State Agency Use Only
____________________________________ __________________________________ Awarding State Agency Planning Start Date
___________________________________________________________________________________ Contract Number or Description
OPM Ethics Form 5 Rev. 10-31-07
STATE OF CONNECTICUT CONSULTING AGREEMENT AFFIDAVIT Solicitation FCL‐0080‐8
Affidavit to accompany a State contract for the purchase of goods and services with a value of $50,000 or more in a calendar or fiscal year, pursuant to Connecticut General Statutes §§ 4a‐81(a) and 4a‐81(b)
INSTRUCTIONS: If the bidder or vendor has entered into a consulting agreement, as defined by Connecticut General Statutes § 4a‐81(b)(1): Complete all sections of the form. If the bidder or vendor has entered into more than one such consulting agreement, use a separate form for each agreement. Sign and date the form in the presence of a Commissioner of the Superior Court or Notary Public. If the bidder or vendor has not entered into a consulting agreement, as defined by Connecticut General Statutes § 4a‐81(b)(1): Complete only the shaded section of the form. Sign and date the form in the presence of a Commissioner of the Superior Court or Notary Public. Submit completed form to the awarding State agency with bid or proposal. For a sole source award, submit completed form to the awarding State agency at the time of contract execution. This affidavit must be amended if the contractor enters into any new consulting agreement(s) during the term of the State contract. AFFIDAVIT: [Number of Affidavits Sworn and Subscribed On This Day: _____ ] I, the undersigned, hereby swear that I am the chief official of the bidder or vendor awarded a contract, as described in Connecticut General Statutes § 4a‐81(a), or that I am the individual awarded such a contract who is authorized to execute such contract. I further swear that I have not entered into any consulting agreement in connection with such contract, except for the agreement listed below: __________________________________________ _______________________________________ Consultant’s Name and Title Name of Firm (if applicable) __________________ ___________________ ___________________ Start Date End Date Cost Description of Services Provided: ___________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Is the consultant a former State employee or former public official? YES NO If YES: ___________________________________ __________________________ Name of Former State Agency Termination Date of Employment Sworn as true to the best of my knowledge and belief, subject to the penalties of false statement. ___________________________ ___________________________________ __________________ Printed Name of Bidder or Vendor Signature of Chief Official or Individual Date ___________________________________ ___________________ Printed Name (of above) Awarding State Agency Sworn and subscribed before me on this _______ day of ____________, 200__.
__________________________________ Commissioner of the Superior Court or Notary Public
OPM Ethics Form 6 Rev. 10-31-07
STATE OF CONNECTICUT AFFIRMATION OF RECEIPT OF STATE ETHICS LAWS SUMMARY Bid 4‐0069
Affirmation to accompany a large State construction or procurement contract, having a cost of more than $500,000, pursuant to Connecticut General Statutes §§ 1‐101mm and 1‐101qq
INSTRUCTIONS: Complete all sections of the form. Submit completed form to the awarding State agency or contractor, as directed below. CHECK ONE:
I am a person seeking a large State construction or procurement contract. I am submitting this affirmation to the awarding State agency with my bid or proposal. [Check this box if the contract will be awarded through a competitive process.]
I am a contractor who has been awarded a large State construction or procurement contract. I am submitting this affirmation to the awarding State agency at the time of contract execution. [Check this box if the contract was a sole source award.]
I am a subcontractor or consultant of a contractor who has been awarded a large State construction or procurement contract. I am submitting this affirmation to the contractor.
IMPORTANT NOTE: Contractors shall submit the affirmations of their subcontractors and consultants to the awarding State agency. Failure to submit such affirmations in a timely manner shall be cause for termination of the large State construction or procurement contract. AFFIRMATION: I, the undersigned person, contractor, subcontractor, consultant, or the duly authorized representative thereof, affirm (1) receipt of the summary of State ethics laws* developed by the Office of State Ethics pursuant to Connecticut General Statutes § 1‐81b and (2) that key employees of such person, contractor, subcontractor, or consultant have read and understand the summary and agree to comply with its provisions. * The summary of State ethics laws is available on the State of Connecticut’s Office of State Ethics website at http://www.ct.gov/ethics/lib/ethics/contractors_guide_final2.pdf
________________________________________________ ____________________ Signature Date ________________________________________________ ____________________________________ Printed Name Title ________________________________________________ Firm or Corporation (if applicable) ________________________________________________ ____________________ ____ ______ Street Address City State Zip
____________________________________
Awarding State Agency
SEEC FORM 11 (Solicitation FCL‐0080‐8)
NOTICE TO EXECUTIVE BRANCH STATE CONTRACTORS AND PROSPECTIVE STATE CONTRACTORS OF CAMPAIGN CONTRIBUTION AND SOLICITATION BAN
This notice is provided under the authority of Connecticut General Statutes 9‐612(g)(2), as amended by P.A. 07‐1, and is for the purpose of informing state contractors and prospective state contractors of the following law (italicized words are defined below): Campaign Contribution and Solicitation Ban No state contractor, prospective state contractor, principal of a state contractor or principal of a prospective state contractor, with regard to a state contract or state contract solicitation with or from a state agency in the executive branch or a quasi‐public agency or a holder, or principal of a holder of a valid prequalification certificate, shall make a contribution to, or solicit contributions on behalf of (i) an exploratory committee or candidate committee established by a candidate for nomination or election to the office of Governor, Lieutenant Governor, Attorney General, State Comptroller, Secretary of the State or State Treasurer, (ii) a political committee authorized to make contributions or expenditures to or for the benefit of such candidates, or (iii) a party committee; In addition, no holder or principal of a holder of a valid prequalification certificate, shall make a contribution to, or solicit contributions on behalf of (i) an exploratory committee or candidate committee established by a candidate for nomination or election to the office of State senator or State representative, (ii) a political committee authorized to make contributions or expenditures to or for the benefit of such candidates, or (iii) a party committee. Duty to Inform State contractors and prospective state contractors are required to inform their principals of the above prohibitions, as applicable, and the possible penalties and other consequences of any violation thereof. Penalties for Violations Contributions or solicitations of contributions made in violation of the above prohibitions may result in the following civil and criminal penalties: Civil penalties‐‐$2000 or twice the amount of the prohibited contribution, whichever is greater, against a principal or a contractor. Any state contractor or prospective state contractor which fails to make reasonable efforts to comply with the provisions requiring notice to its principals of these prohibitions and the possible consequences of their violations may also be subject to civil penalties of $2000 or twice the amount of the prohibited contributions made by their principals. Criminal penalties—Any knowing and willful violation of the prohibition is a Class D felony, which may subject the violator to imprisonment of not more than 5 years, or $5000 in fines, or both. Contract Consequences Contributions made or solicited in violation of the above prohibitions may result, in the case of a state contractor, in the contract being voided. Contributions made or solicited in violation of the above prohibitions, in the case of a prospective state contractor, shall result in the contract described in the state contract solicitation not being awarded to the prospective state contractor, unless the State Elections Enforcement Commission determines that mitigating circumstances exist concerning such violation. The State will not award any other state contract to anyone found in violation of the above prohibitions for a period of one year after the election for which such contribution is made or solicited, unless the State Elections Enforcement Commission determines that mitigating circumstances exist concerning such violation.
Additional information and the entire text of P.A 07‐1 may be found on the website of the State Elections Enforcement Commission, www.ct.gov/seec. Click on the link to “State Contractor Contribution Ban.”
Definitions: "State contractor" means a person, business entity or nonprofit organization that enters into a state contract. Such person, business entity or nonprofit organization shall be deemed to be a state contractor until December thirty‐first of the year in which such contract terminates. "State contractor" does not include a municipality or any other political subdivision of the state, including any entities or associations duly created by the municipality or political subdivision exclusively amongst themselves to further any purpose authorized by statute or charter, or an employee in the executive or legislative branch of state government or a quasi‐public agency, whether in the classified or unclassified service and full or part‐time, and only in such person's capacity as a state or quasi‐public agency employee.
"Prospective state contractor" means a person, business entity or nonprofit organization that (i) submits a response to a state contract solicitation by the state, a state agency or a quasi‐public agency, or a proposal in response to a request for proposals by the state, a state agency or a quasi‐public agency, until the contract has been entered into, or (ii) holds a valid prequalification certificate issued by the Commissioner of Administrative Services under section 4a‐100. "Prospective state contractor" does not include a municipality or any other political subdivision of the state, including any entities or associations duly created by the municipality or political subdivision exclusively amongst themselves to further any purpose authorized by statute or charter, or an employee in the executive or legislative branch of state government or a quasi‐public agency, whether in the classified or unclassified service and full or part‐time, and only in such person's capacity as a state or quasi‐public agency employee.
"Principal of a state contractor or prospective state contractor" means (i) any individual who is a member of the board of directors of, or has an ownership interest of five per cent or more in, a state contractor or prospective state contractor, which is a business entity, except for an individual who is a member of the board of directors of a nonprofit organization, (ii) an individual who is employed by a state contractor or prospective state contractor, which is a business entity, as president, treasurer or executive vice president, (iii) an individual who is the chief executive officer of a state contractor or prospective state contractor, which is not a business entity, or if a state contractor or prospective state contractor has no such officer, then the officer who duly possesses comparable powers and duties, (iv) an officer or an employee of any state contractor or prospective state contractor who has managerial or discretionary responsibilities with respect to a state contract, (v) the spouse or a dependent child who is eighteen years of age or older of an individual described in this subparagraph, or (vi) a political committee established or controlled by an individual described in this subparagraph or the business entity or nonprofit organization that is the state contractor or prospective state contractor.
"State contract" means an agreement or contract with the state or any state agency or any quasi‐public agency, let through a procurement process or otherwise, having a value of fifty thousand dollars or more, or a combination or series of such agreements or contracts having a value of one hundred thousand dollars or more in a calendar year, for (i) the rendition of services, (ii) the furnishing of any goods, material, supplies, equipment or any items of any kind, (iii) the construction, alteration or repair of any public building or public work, (iv) the acquisition, sale or lease of any land or building, (v) a licensing arrangement, or (vi) a grant, loan or loan guarantee. "State contract" does not include any agreement or contract with the state, any state agency or any quasi‐public agency that is exclusively federally funded, an education loan or a loan to an individual for other than commercial purposes.
"State contract solicitation" means a request by a state agency or quasi‐public agency, in whatever form issued, including, but not limited to, an invitation to bid, request for proposals, request for information or request for quotes, inviting bids, quotes or other types of submittals, through a competitive procurement process or another process authorized by law waiving competitive procurement.
“Managerial or discretionary responsibilities with respect to a state contract” means having direct, extensive and substantive responsibilities with respect to the negotiation of the state contract and not peripheral, clerical or ministerial responsibilities.
“Dependent child” means a child residing in an individual’s household who may legally be claimed as a dependent on the federal income tax of such individual.
“Solicit” means (A) requesting that a contribution be made, (B) participating in any fund‐raising activities for a candidate committee, exploratory committee, political committee or party committee, including, but not limited to, forwarding tickets to potential contributors, receiving contributions for transmission to any such committee or bundling contributions, (C) serving as chairperson, treasurer or deputy treasurer of any such committee, or (D) establishing a political committee for the sole purpose of soliciting or receiving contributions for any committee. Solicit does not include: (i) making a contribution that is otherwise permitted by Chapter 155 of the Connecticut General Statutes; (ii) informing any person of a position taken by a candidate for public office or a public official, (iii) notifying the person of any activities of, or contact information for, any candidate for public office; or (iv) serving as a member in any party committee or as an officer of such committee that is not otherwise prohibited in this section.
Form C 07-08-2009
STATE OF CONNECTICUT NONDISCRIMINATION CERTIFICATION Affidavit By Entity – Solicitation FCL‐0080‐8 For Contracts Valued at $50,000 or More
Documentation in the form of an affidavit signed under penalty of false statement by a chief executive officer, president, chairperson, member, or other corporate officer duly authorized to adopt corporate, company, or partnership policy that certifies the contractor complies with the nondiscrimination agreements and warranties under Connecticut General Statutes §§ 4a‐60(a)(1) and 4a‐60a(a)(1), as amended INSTRUCTIONS: For use by an entity (corporation, limited liability company, or partnership) when entering into any contract type with the State of Connecticut valued at $50,000 or more for any year of the contract. Complete all sections of the form. Sign form in the presence of a Commissioner of Superior Court or Notary Public. Submit to the awarding State agency prior to contract execution. AFFIDAVIT: I, the undersigned, am over the age of eighteen (18) and understand and appreciate the obligations of an oath. I am _________________________ of ________________________________ , an entity Signatory’s Title Name of Entity duly formed and existing under the laws of _____________________________________. Name of State or Commonwealth I certify that I am authorized to execute and deliver this affidavit on behalf of ________________________________ and that ________________________________ Name of Entity Name of Entity has a policy in place that complies with the nondiscrimination agreements and warranties of Connecticut General Statutes §§ 4a‐60(a)(1)and 4a‐60a(a)(1), as amended. ___________________________________________ Authorized Signatory ___________________________________________ Printed Name Sworn and subscribed to before me on this ______ day of ____________, 2009. _________________________________________ ___________________________________ Commissioner of the Superior Court/ Commission Expiration Date Notary Public
Form A 07-08-2009
STATE OF CONNECTICUT NONDISCRIMINATION CERTIFICATION — Representation By Individual For All Contract Types Regardless of Value Solicitation FCL‐0080‐8
Written representation that complies with the nondiscrimination agreements and warranties under Connecticut General Statutes §§ 4a‐60(a)(1) and 4a‐60a(a)(1), as amended INSTRUCTIONS: For use by an individual who is not an entity (corporation, limited liability company, or partnership) when entering into any contract type with the State of Connecticut, regardless of contract value. Submit to the awarding State agency prior to contract execution. REPRESENTATION OF AN INDIVIDUAL: I, _____________________________, of ____________________________________________, Signatory Business Address represent that I will comply with the nondiscrimination agreements and warranties of Connecticut
General Statutes §§ 4a-60(a)(1)and 4a-60a(a)(1), as amended.
_________________________________ ___________________________________ Signatory Date ___________________________________________ Printed Name
